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New experience with robotic flexible ureteroscopy in renal stones (report of 200 cases)
32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom
V56
New experience with robotic flexible ureteroscopy in renal stones (report of 200 cases) Eur Urol Suppl 2017; 16(3);e2112
Geavlete P.A.1, Saglam R.2, Georgescu D.3, Multescu R.3, Mirciulescu V.3, Kabakci A.S.4, Geavlete B.3 1
Sanador Hospital, Dept. of Urology, Bucharest, Romania, 2Medicana International Hospital, Dept. of Urology, Ankara, Turkey, 3Saint John Clinical Hospital, Dept. of Urology, Bucharest, Romania, 4 Hacettepe University, Dept. of Bioengineering, Ankara, Turkey INTRODUCTION & OBJECTIVES: Roboflex Avicenna represents a new device for flexible ureteroscopy, able to provide an efficient lithotripsy for renal calculi, Bucharest being the fourth place in the world where such a device is already in use. We present our experience on robotic flexible ureteroscopy. MATERIAL & METHODS: In the last year, 200 cases with renal stone were treated by robotic flexible ureteroscopy. The mean stone size was 2.4 cm (between 1 and 3.7 cm). The stone location was lower calyx in 49 cases, middle calyx in 28 cases, upper calyx in 7 cases and pyelic in 84 cases. 32 patients presented multiple renal stones. All procedures were performed with the patient under general anesthesia, a flexible ureteroscope Storz XC being used in association with Avicenna Roboflex. Stone fragmentation was performed using a Dornier Medilas 20H, Holmium Laser of 20 watt power and 2.1 μm wave length. Concerning the technique, the flexible robotic catheter system was manually introduced into the renal collecting system over a guide wire under fluoroscopic control of the endoscope. The surgeon operated from the console, controlling two joy-sticks to manipulate the rotation, deflection and in and out movement of the endoscope. All intrarenal maneuvers, including stone relocation and fragmentation into 1 to 2 mm particles, were done exclusively from the remote robotic console. RESULTS: The stone free rate after 3 months was 92.5%. Residual fragments smaller than 3 mm were described in 12.5% cases. Re-treatment rate was 9.5%. No significant intraoperative complication were encountered. Concerning the ergonomic position, robotic flexible ureteroscopy offers a better operatory comfort than flexible ureteroscopy, because of the position of the surgeon. CONCLUSIONS: Roboflex Avicenna represents a new device for flexible ureteroscopy, able to provide an efficient lithotripsy for renal calculi. It provides an increased ergonomic position for the surgeon but with an overall relatively similar outcome. Using the Avicenna Robolfex increases the safety for the patient and ureteroscope.
Eur Urol Suppl 2017; 16(3);e2112 Powered by TCPDF (www.tcpdf.org)
V56
New experience with robotic flexible ureteroscopy in renal stones (report of 200 cases) Eur Urol Suppl 2017; 16(3);e2112
Geavlete P.A.1, Saglam R.2, Georgescu D.3, Multescu R.3, Mirciulescu V.3, Kabakci A.S.4, Geavlete B.3 1
Sanador Hospital, Dept. of Urology, Bucharest, Romania, 2Medicana International Hospital, Dept. of Urology, Ankara, Turkey, 3Saint John Clinical Hospital, Dept. of Urology, Bucharest, Romania, 4 Hacettepe University, Dept. of Bioengineering, Ankara, Turkey INTRODUCTION & OBJECTIVES: Roboflex Avicenna represents a new device for flexible ureteroscopy, able to provide an efficient lithotripsy for renal calculi, Bucharest being the fourth place in the world where such a device is already in use. We present our experience on robotic flexible ureteroscopy. MATERIAL & METHODS: In the last year, 200 cases with renal stone were treated by robotic flexible ureteroscopy. The mean stone size was 2.4 cm (between 1 and 3.7 cm). The stone location was lower calyx in 49 cases, middle calyx in 28 cases, upper calyx in 7 cases and pyelic in 84 cases. 32 patients presented multiple renal stones. All procedures were performed with the patient under general anesthesia, a flexible ureteroscope Storz XC being used in association with Avicenna Roboflex. Stone fragmentation was performed using a Dornier Medilas 20H, Holmium Laser of 20 watt power and 2.1 μm wave length. Concerning the technique, the flexible robotic catheter system was manually introduced into the renal collecting system over a guide wire under fluoroscopic control of the endoscope. The surgeon operated from the console, controlling two joy-sticks to manipulate the rotation, deflection and in and out movement of the endoscope. All intrarenal maneuvers, including stone relocation and fragmentation into 1 to 2 mm particles, were done exclusively from the remote robotic console. RESULTS: The stone free rate after 3 months was 92.5%. Residual fragments smaller than 3 mm were described in 12.5% cases. Re-treatment rate was 9.5%. No significant intraoperative complication were encountered. Concerning the ergonomic position, robotic flexible ureteroscopy offers a better operatory comfort than flexible ureteroscopy, because of the position of the surgeon. CONCLUSIONS: Roboflex Avicenna represents a new device for flexible ureteroscopy, able to provide an efficient lithotripsy for renal calculi. It provides an increased ergonomic position for the surgeon but with an overall relatively similar outcome. Using the Avicenna Robolfex increases the safety for the patient and ureteroscope.
Eur Urol Suppl 2017; 16(3);e2112 Powered by TCPDF (www.tcpdf.org)